S 2320
110th CONGRESS
1st Session
S. 2320
To amend title XVIII of the Social Security Act to provide
continued entitlement to coverage for immunosuppressive drugs furnished
to beneficiaries under the Medicare Program that have received a kidney
transplant and whose entitlement to coverage would otherwise expire,
and for other purposes.
IN THE SENATE OF THE UNITED STATES
November 7, 2007
Mr. DURBIN (for himself and Mr. COCHRAN) introduced the following bill;
which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act to provide
continued entitlement to coverage for immunosuppressive drugs furnished
to beneficiaries under the Medicare Program that have received a kidney
transplant and whose entitlement to coverage would otherwise expire,
and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Comprehensive Immunosuppressive Drug Coverage
for Kidney Transplant Patients Act of 2007'.
SEC. 2. PROVISION OF APPROPRIATE COVERAGE OF IMMUNOSUPPRESSIVE DRUGS
UNDER THE MEDICARE PROGRAM FOR KIDNEY TRANSPLANT RECIPIENTS.
(a) Continued Entitlement to Immunosuppressive Drugs-
(1) KIDNEY TRANSPLANT RECIPIENTS- Section 226A(b)(2) of the Social
Security Act (42 U.S.C. 426-1(b)(2)) is amended by inserting `(except
for coverage of immunosuppressive drugs under section 1861(s)(2)(J))'
after `shall end'.
(2) APPLICATION- Section 1836 of the Social Security Act (42 U.S.C.
1395o) is amended--
(A) by striking `Every individual who' and inserting `(a) In General-
Every individual who'; and
(B) by adding at the end the following new subsection:
`(b) Special Rules Applicable to Individuals Only Eligible for Coverage
of Immunosuppressive Drugs-
`(1) IN GENERAL- In the case of an individual whose eligibility for
benefits under this title has ended except for the coverage of immunosuppressive
drugs by reason of section 226A(b)(2), the following rules shall apply:
`(A) The individual shall be deemed to be enrolled under this part
for purposes of receiving coverage of such drugs.
`(B) The individual shall be responsible for the full amount of
the premium under section 1839 in order to receive such coverage.
`(C) The provision of such drugs shall be subject to the application
of--
`(i) the deductible under section 1833(b); and
`(ii) the coinsurance amount applicable for such drugs (as determined
under this part).
`(D) If the individual is an inpatient of a hospital or other entity,
the individual is entitled to receive coverage of such drugs under
this part.
`(2) ESTABLISHMENT OF PROCEDURES IN ORDER TO IMPLEMENT COVERAGE- The
Secretary shall establish procedures for--
`(A) identifying beneficiaries that are entitled to coverage of
immunosuppressive drugs by reason of section 226A(b)(2); and
`(B) distinguishing such beneficiaries from beneficiaries that are
enrolled under this part for the complete package of benefits under
this part.'.
(3) TECHNICAL AMENDMENT- Subsection (c) of section 226A of the Social
Security Act (42 U.S.C. 426-1), as added by section 201(a)(3)(D)(ii)
of the Social Security Independence and Program Improvements Act of
1994 (Public Law 103-296; 108 Stat. 1497), is redesignated as subsection
(d).
(b) Extension of Secondary Payer Requirements for ESRD Beneficiaries-
Section 1862(b)(1)(C) of the Social Security Act (42 U.S.C. 1395y(b)(1)(C))
is amended by adding at the end the following new sentence: `With regard
to immunosuppressive drugs furnished on or after the date of enactment
of the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant
Patients Act of 2007, this subparagraph shall be applied without regard
to any time limitation.'.
(c) Effective Date- The amendments made by this section shall apply
to drugs furnished on or after the date of enactment of this Act.
SEC. 3. PLANS REQUIRED TO MAINTAIN COVERAGE OF IMMUNOSUPPRESSIVE DRUGS
FOR KIDNEY TRANSPLANT RECIPIENTS.
(a) Application to Certain Health Insurance Coverage-
(1) IN GENERAL- Subpart 2 of part A of title XXVII of the Public Health
Service Act (42 U.S.C. 300gg-4 et seq.) is amended by adding at the
end the following:
`SEC. 2707. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT
RECIPIENTS.
`A group health plan (and a health insurance issuer offering health
insurance coverage in connection with a group health plan) shall provide
coverage of immunosuppressive drugs in connection with a kidney transplant
that is at least as comprehensive as the coverage provided by such plan
or issuer on the day before the date of enactment of the Comprehensive
Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of
2007, and such requirement shall be deemed to be incorporated into this
section.'.
(2) CONFORMING AMENDMENT- Section 2721(b)(2)(A) of the Public Health
Service Act (42 U.S.C. 300gg-21(b)(2)(A)) is amended by inserting
`(other than section 2707)' after `requirements of such subparts'.
(b) Application to Group Health Plans and Group Health Insurance Coverage
Under the Employee Retirement Income Security Act of 1974-
(1) IN GENERAL- Subpart B of part 7 of subtitle B of title I of the
Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et
seq.) is amended by adding at the end the following new section:
`SEC. 714. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT
RECIPIENTS.
`A group health plan (and a health insurance issuer offering health
insurance coverage in connection with a group health plan) shall provide
coverage of immunosuppressive drugs in connection with a kidney transplant
that is at least as comprehensive as the coverage provided by such plan
or issuer on the day before the date of enactment of the Comprehensive
Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of
2007, and such requirement shall be deemed to be incorporated into this
section.'.
(2) CONFORMING AMENDMENTS-
(A) Section 732(a) of the Employee Retirement Income Security Act
of 1974 (29 U.S.C. 1191(a)) is amended by striking `section 711'
and inserting `sections 711 and 714'.
(B) The table of contents in section 1 of the Employee Retirement
Income Security Act of 1974 is amended by inserting after the item
relating to section 713 the following new item:
`Sec. 714. Coverage of immunosuppressive drugs.'.
(c) Application to Group Health Plans Under the Internal Revenue Code
of 1986- Subchapter B of chapter 100 of the Internal Revenue Code of
1986 is amended--
(1) in the table of sections, by inserting after the item relating
to section 9812 the following new item:
`Sec. 9813. Coverage of immunosuppressive drugs for kidney transplant
recipients.';
(2) by inserting after section 9812 the following:
`SEC. 9813. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT
RECIPIENTS.
`A group health plan shall provide coverage of immunosuppressive drugs
in connection with a kidney transplant that is at least as comprehensive
as the coverage provided by such plan on the day before the date of
enactment of the Comprehensive Immunosuppressive Drug Coverage for Kidney
Transplant Patients Act of 2007, and such requirement shall be deemed
to be incorporated into this section.'.
(d) Effective Date- The amendments made by this section shall apply
to plan years beginning on or after January 1, 2008.
END
